Otologi

1. The external auditory canal (EAC) develops from:

A. The first mesodermal branchial groove between the mandibular (I) hyoid (II) arches
B. The first ectodermal branchial groove between the mandibular (I) and hyoid (II)
arches
C. The second pharyngeal pouch joining the first pharyngeal groove
D. The second branchial groove joining the second pharyngeal pouch
E. Entirely from the third ectodermal branchial groove

2. Which of the following can be inferred from the type of fracture present on CTscan?

A. Patients with otic capsule-sparing fractures are less likely to have cerebrospinal
fluid (CSF) fistula.
B. Facial nerve injury is more likely when the otic capsule is not involved.
C. Sensorineural hearing loss is not related to the type of fracture present.
D. Otic capsule-sparing fractures typically result from a blow to the occipital region.

3. The initial treatment of patients presenting within 72 hours of onset of Bell palsy should
include:

A. Steroids, antivirals and eye care

B. Steroids and eye care
C. Antivirals and eye care
D. Eye care, no further treatment (prognosis not improved)
E. No further treatment (prognosis not improved)

4. Where is the most common site for a dehiscent facial nerve?

A. Meatal segment
B. Tympanic segment
C. Labyrinthine segment
D. Mastoid segment

5. Where is the most common site of origin of congenital cholesteatoma?

A. Epitympanum
B. Posterior-superior quadrant of the middle ear
C. Anterior-superior quadrant of the middle ear
D. Mastoid antrum
6. Diagnosis of autoimmune inner ear disease (AIED) is made based on:
A. Clinical pattern and treatment response consistent with the disease
B. Serologic testing
C. History and physical examination findings
D. Clinical history and positron emission tomography (PET) imaging

7. Salient clinical features supporting the diagnosis of necrotizing external otitis (NEO)
include:
 A. Persistent otalgia for more than 1 month, solitary polyp in otherwise dry external ca-
nal, nondiabetic patient
B. Persistent otalgia for more than1month,persistent purulence,perforation of the tym
panic membrane, younger patient
C. Acute, exquisite otalgia for 24 to 48 hours, purulent discharge from the external
canal, swollen external canal, shoddy periauricular lymphadenopathy
D. Acute, exquisite otalgia for 1 week, purulent discharge from the external canal,
swollen external canal, older patient
E. Persistent otalgia for more than 1 month, persistent purulent granulation
tissue, dia betes mellitus, advanced age, immunocompromised state
8. Where is the most common site of origin of acquired cholesteatoma?
A. Anteriorepitympanum
B. Posterior epitympanum
C. Posterior mesotympanum
D. Anteriormesotympanum
E. Inferior mesotympanum
9. Which complication would be expected to occur more often with overlay as compared to
underlay tympanoplasty techniques?
A. Malleus fixation to the anterior canal wall by scar tissue
B. Graft failure due to medial displacement
C. Excessive postoperative middle-ear adhesions
D. Postoperative middle-ear effusion
10. An 8-year-old trauma patient. The arrow indicates:

A. A normal suture line

B. The vestibular aqueduct
C. The superior petrosal vein
D. The subarcuate canal
E. A capsule-violating temporal bone fracture
11. A pregnant woman in third trimester complains of hearing her own sounds. Examination
of the earn shows movement of tympanic membrane synchronous with respiration and
especially exaggerated when nostril on the contralateral side is occluded. Your diagnosis
is:
A. Eustachian tube obstruction
 B. Patulous eustachian tube
C. Otitis media with effusion
D. Otosclerosis
12. Seorang laki, umur 50 th, merasa telinga kiri berdenging sejak 2 th yang lalu, terus menerus
semakin berat, sejak 1 tahun yang lalu merasa pendengaran berkurang. Pada pemeriksaan
otoskopi : dalam batas normal, pemeriksaan penunjang : audiogram telinga kiri tull
sensorineural, pemeriksaan Impedance dalam batas normal, pemeriksaan OAE : telinga
kanan dan kiri : pass, diagnosis yang paling mungkin pada kasus ini adalah :
A. Gangguan vascularisasi stria vaskularis
B. Ototoksis
C. Otosclerosis
D. Acustic neuroma
E. Gangguan pada batang otak

13. Berikut ini yang termasuk komplikasi lanjut pada Mastoidektomi adalah :
A. Perdarahan
B. Parese nervus facial
C. Stenosis kanalis eksterna
D. Herniasi otak
E. Kebocoran cairan serebrospinal

14. Pada gangguan nervus VII, test lacrimal (+), terjadi gangguan pengecapan. Dimana letak
lesinya?
A. Foramen genikulatum
B. segmen timpani
C. Segmen labirin
D. Segment mastoid

15. Which of the following best describes the boundaries of Prussak space?
A. Neck of the malleus medially, pars flaccida laterally, scutum superiorly and
lateral process of malleus inferiorly
B. Anterior and posterior malleolar folds medially and tympanic membrane laterally
C. Facial nerve medially, tympanic annulus and chorda tympani laterally, and incus
buttress superiorly
D. Posterior semicircular canal medially; pyramidal eminence, stapedius muscle, and
facial nerve laterally. Ponticulus superiorly and subiculum inferiorly
16. The most common site for dehiscence of the facial canal is:
A. Vertical segment
B. Horizontal segment
C. Labyrinthine segment
D. Meatal foramen
E. Second genu
17. Which of the following conditions will give maximum conductive hearing loss?
A. Complete obstruction of ear canal
B. Disruption of ossicular chain with intact tympanic membrane
C. Disruption of ossicular chain with perforation of tympanic membrane
D. Perforation of tympanic membrane with intact ossicular chain
18. Landmark used for identification of geniculate ganglion of facial nerve is:
A. Oval window
B. Processus cochleariformis
C. Pyramid
D. Digastric ridge

19. Gradenigo syndrome is characterized by which of the following?

A. Vertigo, tinnitus and fluctuative sensorineural hearing loss
B. Otorrhea, ipsilateral abducens palsy and pain in trigeminal distribution
C. Fever and otalgia, followed by otorrhea
D. Hearing loss, vertigo and tinnitus
E. Retroorbital pain, otorrhea and vertigo
20. A retracted tympanic membrane adherent to the promontory is described as:
A. Sade grade 1
B. Sade grade 2
C. Sade grade 3
D. Sade grade 4
E. Sade grade 5
21. Which of the following is the most common cause of conductive deafness in a patient with
a longitudinal fracture of the temporal bone?
A. Hemotympanum
B. Dislocation of malleus
C. Tympanic membrane perforation
D. Perilymph fistula
E. Malleoincudal disclocation
22. Regarding the evaluation of a patient with a facial nerve injury, which of the following
statements is incorrect?
A. Conduction block only with no physical disruption of axonal discontinuity
correlates with Sunderland’s first-degree injury
B. Transection of the epineurium correlates with Sunderland’s second-degree
injury
C. Transection of the endoneurium correlates with Sunderland’s third-degree injury
D. Synkinesis refers to the loss of discrete facial movements after facial nerve injury
E. Topodiagnostic testing has little correlation with the site of injury to the facial nerve
23. Which of the following would best distinguish a radical mastoidectomy procedure?
A. Ossicular chain reconstruction using a total ossicular replacement prosthesis
B. Creation of a wide meatoplasty
C. Lowering of the facial ridge
D. Canaloplasty
E. Occlusion of the eustachian tube
NO
1. Modalities to monitor ototoxicity include:
A. Standard pure-tone audiometry
B. High-frequency audiometry
C. Distortion-produced otoacoustic emissions (OAEs)
D. All of the above
E. A and C

2. Which of the following branches of the facial nerve is most proximal?

A. Branch to the digastric

B. Chorda tympani
C. Branchtoplatysma
D. Greater superficial petrosal nerve
E. Branch to the stapedius

3. Which of the following is characteristic of right posterior semicircular canal BPPV

(benign paroxysmal positional vertigo)?
A. With the right ear positioned toward the ground in the Dix-Hallpike maneuver, the
resulting nystagmus is pure horizontal geotropic.
B. With the right ear positioned toward the ground in the Dix-Hallpike maneuver, the
resulting nystagmus is downbeating, geotropic, and torsional.
C. With the right ear positioned toward the ground in the Dix-Hallpike maneuver, the
resulting nystagmus is downbeating, ageotropic, and torsional.
D. With the right ear positioned toward the ground in the Dix-Hallpike maneuver,
the resulting nystagmus is upbeating, geotropic, and torsional.
E. With the right ear positioned toward the ground in the Dix-Hallpike maneuver, the
resulting nystagmus is upbeating, ageotropic, and torsional.

4. Which ofthese are the most common drugs causing ototoxicity?

A. Loop diuretics
B. Aminoglycosides
C. Cisplatin
D. Vancomycin
E. B and C

5. Which statement is incorrect regarding otoacoustic emissions (OAEs)?

A. They are a comprehensive test of hearing.

B. They reflect outer hair cell function.
C. They are often normal in auditory neuropathy.
D. They may be used to monitor ototoxicity.
 E. They can differentiate cochlear from retrocochlear pathology.

6. Arah nystagmus vestibuler yang terjadi pada BPPV ditentukan oleh:

A. Masa laten nystagmus
B. Fase lambat nystagmus
C. Fase cepat nystagmus
D. Fatig nystagmus
E. Lama nystagmus
7. A patient with a long history ofunilateral hearing loss and intermittent otorrhea complains
of vertigo when exposed to loud sounds and whenever manipulating his auricle. The most
likely explanation of these symptoms is:
A. Superior semicircular canal dehiscence syndrome
B. Endolymphatic hydrops related to prior serous labyrinthitis
C. Postinflammatory Meniere disease
D. Semicircular canal fistula due to cholesteatoma
E. Suppurative labyrinthitis

8. A 1.5-year-old child with bilateral aural atresia should be offered: (1)

A. Atresia surgery on at least one ear by age 3 years

B. Bone-anchored hearing aid (BAHA) soft band
C. BAHA implant by age 2 years
D. Aural-oral rehabilitation

9. A 25 year old woman suffering from bilateral hearing loss for 6 years which became
profound with pregnancy. On tympanogram, which of the following curve is obtained?
A. Ad
B. As
C. B
D. A

10. Otoacoustic emissions are produced by:

A. Inner hair cells
B. Outer hair cells
C. Basilar membrane
D. Auditory nerve

11. Tes keseimbangan yang dapat menentukan adanya hipofungsi kanal vestibuler bilateral:
A. Head shaking tes
B. Head impulse/thrust tes
C. Romberg tes
D. Stepping tes
E. Visual dynamic acuity tes

12. caloric test determines function of:

A. superior semicircular canal
 B. lateral semicircular canal
C. posterior semicircular canal
D. utricle

13. Pada pemeriksaan BERA engan stimulus click intensitas 80dBnHL, didapatkan hasil
sebagai berikut
Masa laten glb I masa laten glb II glb III
Telinga kanan 2,3 4,1 6,3
Telinga kiri 1,4 3,9 5,9
Maka kesimpulan yang paling mungkin dari hasil pemeriksaan tersebut adalah
A. Gangguan dengar konduktif telinga kiri
B. Gangguan dengar konduktif telinga kanan
C. Sistem pendengaran perifer telinga kiri dalam batas normal
D. Sistem pendengaran perifer telinga kanan dalam batas normal
E. Sistem pendengaran perifer pada kedua telinga dalam batas normal

14. Seorang perempuan 35 tahun mengeluh kesulitan dalam berkomunikasi, sering meminta
lawan bicaranya mengulang percakapan. Penderita tidak ingat kapan keluhan tersebut
mulai dirasakan. Pada pemeriksaan audiogram nada murni didapatkan nilai ambang dengar
telinga kanan 58dB dan kiri 55 dB, dengan nilai diskriminasi ttur kanan 95% dari kiri 100%
kemungkinan penyakit adalah
A. Otosklerosis
B. Penyakit metabolik
C. Presbiakusis prekok
D. Efek ototoksik analgetik
E. Kerusakan pusat bicara di otak
15. Audiogram in early Meniere disease shows:
A. Notch at 2 kHz in bone conduction
B. Notch at 4 kHz in air conduction
C. A flat curve
D. A rising curve

16. Smallest segment of facial nerve is:

A. Intracanalicular
B. Labyrinthine
C. Tympanic
D. Mastoid
E. Parotid segment before its division
17. On performing a tuning fork exam, a positive Rinne (air greater than bone conduction) is
seen at 1024 Hz, but negative Rinne (bone greater than air conduction) at 512 and 256 Hz.
Which of the following degrees of hearing loss is suggested by this
A. < 15 dB HL
B. 15 to 30 dB HL
C. 30 to 45 dB HL
D. 45 to 60 dB HL
E. 60 to 85 dB HL
18. Which of the following is a contraindication for cochlear implantation?
 A. Absence of the cochlear nerve on MRI
B. Enlarged vestibular aqueduct
C. Michel anomaly
D. Anomalous cochlea
E. Anomalous vestibule
19. Which of the following waves is present on ABR in the context of significant hearing loss?
A. Wave I
B. Wave II
C. Wave III
D. Wave IV
E. Wave V
20. Wave IV on the ABR corresponds to which of the following?
A. Proximal cochlear nerve
B. Distal cochlear nerve
C. Superior vestibular nerve
D. Superior olivary complex
E. Inferior colliculus
21. Which of the following is consistent with a positive Tullio fign?
A. Nystagmus produced by pneumatic otoscopy
B. Dizziness induced by loud sounds
C. Sensitivity to normal, everyday sounds
D. Gaze-evoked tinnitus
E. Apparent movement of objects in the visual field
22. which of the following waves on ABR testing is the most sensitive to hearing loss?
A. Wave I
B. Wave II
C. Wave III
D. Wave IV
E. Wave V
23. Regarding stapedial reflex, which of the following is true?
A. It helps to enhance the sound conduction in middle ear
B. It is a protective reflex against loud sounds
C. It helps in masking the sound waves
D. It is unilateral reflex
24. In cold caloric stimulation test, the cold water induced movement of the eye ball in the
following direction:
A. Towards the opposite site
B. Towards the same side
C. Upwards
D. Downwards
THT Kom

1. Hearing conservation programs are required by Occupational Safety and Health

Administration for workers whose time-weighted average 'IWA(s) exposures are at least
which dBA level? (7)

A. 80
B.
C. 82
D. 85
E. 87
F. 90

2. Kelainan dibawah ini termasuk target kegiatan PGPKT THT Komunitas:

A. Tuli mendadak
B. Penyakit Otitis eksterna
C. Tuli akibat bising
D. Tuli akibat obat ototoksik
E. Otosklerosis

3. Tahapan awal dalam pemetaan menentukan penyebab ketulian pada pekerja industri dengan
kebisingan:
A. Pemeriksaan audiometri pekerja industri
B. Mapping titik-titik sumber bising dilokasi industri
C. Lokasi/ divisi pekerja di industri tempat bekerja
D. Status pendengaran saat masuk sebagai pekerja
E. Status pendengaran saat diukur audiometric

4. Keberhasilan UNHS:
A. cover rate 90% dan refferal 4 %
B. cover rate 50% dan refferal 4 %
C. cover rate 30% dan refferal 4 %
D. cover rate 20% dan refferal 4 %
E. cover rate 1 0% dan refferal 4 %
5. Pasien berusia 24 bulan mengalami keterlambatan bicara. Seharusnya pasien sudah
memiliki kemampuan membaca:
A. Babbling
B. Jargon
C. Merangkai 2 kata
D. Mengikuti instruksi yang terdiri dari 2 kata

6. Pernyataan yang paling tepat pada analisa dan interpretasi hasil skrining pendengaran pada
anak sekolah
A. 40 dB pada frekuensi 500,1000,2000 dan 4000 Hz lulus skrining
B. >40 dB pada frekuensi 500,1000,2000 dan 4000 Hz lulus skrining
C. >40 dB pada frekuensi 500,1000,2000 dan 4000 Hz lulus skrining
D. >40 dB pada frekuensi 500 Hz dan 40 dB pada 1000,2000 dan 4000 Hz dengan bising
>40 dB lulus skrining
E. >40 dB pada frekuensi 500 Hz dan 40 dB pada 1000,2000 dan 4000 dan terdapat
lateralisasi pada weber lulus skrining
7. Pemeriksaan audiologi terbaik untuk anak berusia 5 bulan :
A. BOA
B. VRA
C. Conditional play audiometry
D. immitance audiometry
E. ABR
8. Pengukuran kualitas hidup generik yang paling banyak diketahui dan luas penggunaanya
adalah:
A. Medical Outcomes Study Short Form 36
B. The University of Washington Quality Life Scale
C. The Quality of Well Being Index
D. The Health Utilities Index
9. Berikut ini adalah pernyataan yang benar mengenai SNOT-20:
A. Merupakan pengukuran kualitas hidup yang bersifat generic
B. Merupakan versi pendek dari 31-item Rhinosinusitis Outcome Measure (RSOM-
31)
C. Perubahan skor merefleksikan perubahan secara klinik
D. Merupakan pengukuran untuk sinusitis akut dan kronis
10. Pemeriksaan yang sering digunakan untuk menilai derajat kekantukan di siang hari adalah:
A. FACT-HN
B. ESS
 C. SNOT-22
D. HHIE
11. Pemasangan ABD pada anak dgn tuli sejak lahir sesuai dengan alur skrining pendengaran
bayi baru lahir adalah:
A. Setelah anak berusia 4 tahun
B. Pada anak usia prasekolah umum
C. Sejak lahir
D. Mulai usia 3 tahun
E. Mulai usia 6 bulan
12. Which one of the following is commonly associated with Temporary Threshold Shift?
A. Presbycusis
B. Tone decay
C. Noise exposure
D. Ototoxic drug
E. Meniere’s disease
13. Penyebab gangguan pendengaran paling sering:
A. ear wax
B. Otitis media kronik
C. Otitis media efusi
D. NIHL
E. Tuli kongenital
14. Seorang laki-laki, mendapatkan terapi mengenai gangguan telinga, yang paling banyak
digunakan adalah penilaian dengan menggunakan questioner berikut :
A. SF-36
B. RQLQ
C. WHO-QOL
D. SNOT 22
E. SNOT 20
15. Ciri-ciri awal presbiakusis murni:
A. Proses aging, audiogram: nilai ambang AC & BC berimpit, meningkat nada
rendah
B. Proses aging, audiogram: nilai ambang AC & BC berimpit, meningkat nada tinggi
C. Proses aging, audiogram: nilai ambang AC & BC meningkat, nada rendah bisa
ada gap < 15dB
D. Proses aging, audiogram: nilai ambang AC & BC meningkat, nada tinggi
bisa ada gap < 15dB
E. Setiap penurunan tajam pendengaran pada usia lanjut
16. Salah satu faktor kausa Sosioakusis adalah:
A. Proses degenerasi saja
B. Proses aging saja
C. Adanya penyakit metabolik hipertiroid
D. Adanya penyakit sindroma metabolik
E. Adanya penyakit metabolik hipotiroid
17. Skrining pendengaran ulang pada anak usia sekolah dilakukan pada saat anak berada di
kelas :
A. Kelas 1
B. Kelas3
C. Kelas 4
D. Kelas 5
E. Kelas 6
18. Manajemen terpenting terhadap ketulian pekerja industri dengan kebisingan:
A. Keluar/ pensiun dini sebagai pekerja
B. Menghindari sumber bising
C. Menggunakan alat pelindung diri helmet + ear plug
D. Menggunakan alat pelindung diri helmet + earmuff
E. Menggunakan alat pelindung diri earmuff + earplug
19. Berikut ini adalah faktor-faktor risiko yang bukan penyebab terjadinya tuli kongenital;

A. Lahir dengan kelainan maksilofasial

B. Lahir dengan kelainan kongenital pada organ lain
C. Pada saat kehamilan trimester pertama ibu rnengalami infeksi virussitomegali

D. Berat badan lahir 2500 gram

E. Kern icterus

20. Pada skrining pendengaran pada anak sekolah, dinyatakan lulus skrining bila
menunjukkan respons rata- rata pada frekuensi 500 Hz, 1000 Hz, 2000 Hz, 4000 Hz pada
intensitas;
A. 30 dB
B. 35 dB
C. 40 dB
D. 45 dB
E. 50 db
21. Pada Program Universal Newborn Hearing Screening (UNHS), deteksi dini terhadap
gangguan pendengaran sudah dimulai pada saat bayi berusia 2 hari atau sebelum keluar
dan rumah sakit. Untuk bayi yang tidak dilahirkan dirumah sakit, skrining sudah harus
dilakukan pada usia ;

A. 1 bulan
B. 3 bulan
C. 6 bulan
D. 1tahun
E. 3 tahun

22. Guidline for the detection of hearing loss among infants have been provided by the
multydisciplinary Joint Commitee on Infant Hearing. The commitee endorses universal
detection of infant hearing loss by ;

A. 3 months of age and intervation by 6 months of age.

B. 1 month of age and intervation by 6 months of age.
C. 6 months of age and intervation by 6 months of age.
D. 3 months of age and intervation by 12 months of age.
E. 6 months of age and intervation by 12 months of age.
23. Periode yang paling efektif dan optimal dari seluruh kehidupan manusia guna belajar
bicara adalah;

A. sebelum 6 bulan
B. 6 bulan sampai 3 tahun
C. 3 sampai 6 tahun
D. 9 bulan sampai 3 tahun
E. 12 bulan sampai 3 tahun